Provider Demographics
NPI:1861684615
Name:JAMES MAKEMSON MD PC
Entity Type:Organization
Organization Name:JAMES MAKEMSON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-880-4690
Mailing Address - Street 1:250 CHATEAU DR SW
Mailing Address - Street 2:STE. 210
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6436
Mailing Address - Country:US
Mailing Address - Phone:256-880-4690
Mailing Address - Fax:256-880-4691
Practice Address - Street 1:250 CHATEAU DR SW
Practice Address - Street 2:STE. 210
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6436
Practice Address - Country:US
Practice Address - Phone:256-880-4690
Practice Address - Fax:256-880-4691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I18084Medicare UPIN